Provider Demographics
NPI:1699845016
Name:MEMORIAL HEALTH CARE SYSTEMS
Entity Type:Organization
Organization Name:MEMORIAL HEALTH CARE SYSTEMS
Other - Org Name:MHCS CLINIC PROFESSIONAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:E
Authorized Official - Last Name:JERGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-643-2971
Mailing Address - Street 1:250 N COLUMBIA AVE
Mailing Address - Street 2:
Mailing Address - City:SEWARD
Mailing Address - State:NE
Mailing Address - Zip Code:68434-2248
Mailing Address - Country:US
Mailing Address - Phone:402-643-4800
Mailing Address - Fax:402-646-4635
Practice Address - Street 1:300 N COLUMBIA AVE
Practice Address - Street 2:
Practice Address - City:SEWARD
Practice Address - State:NE
Practice Address - Zip Code:68434-2299
Practice Address - Country:US
Practice Address - Phone:402-643-2971
Practice Address - Fax:402-646-4605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE60086OtherBCBS OF NE (MILFORD)
NE60087OtherBCBS OF NEBRASKA (SEWARD)
NE06053OtherBCBS OF NEBRASKA (UTICA)
NE=========11Medicaid
NE60087OtherBCBS OF NEBRASKA (SEWARD)
NE60086OtherBCBS OF NE (MILFORD)
NE=========12Medicaid
NE60087OtherBCBS OF NEBRASKA (SEWARD)